In accordance with the stated objectives of the Preventive Pulmonary Academic Award, an integrated, multi-disciplinary program that promotes the values, attitudes, and clinical behaviors that are essential to the prevention of respiratory diseases and disabilities will be established. This goal will be achieved at the Bowman Gram School of Medicine of Wake Forest University in the following manner: 1) Major changes in the undergraduate and graduate medical curricula will be made. new instruction and shifts in emphases of previous instruction toward Pulmonary Prevention will be introduced, with emphasis upon learning experiences enhancing opportunities for practice of prevention. Changes will be achieved in curricula in the Traditional, largely lecture-based medical Curriculum, and in an innovative problem-based learning program, the Parallel curriculum. Modifications will also be focused initially within the Department of Medicine House Staff Program, with plans to extend initiatives with proven worth to other departments. using state of the art, validated evaluative instruments, the impact of changes will be evaluated critically, 2) In a milieu available at only a few centers in the United States, a Research Project designed to assess whether the timing (early, during years 1 and 2 vs late, years 3 and 4) and mode of instruction (passive, didactic vs. active, Socratic) in Preventive Pulmonary Principles and Interventions will be performed. Results of this investigation will influence plans for future curricula modifications. Control and intervention (preventive Pulmonary) groups within the Traditional and Parallel Curricula have been defined. Methods for evaluating clinical skills and performances will include Individualized Process Assessments (video taped interactions with standardized, simulated patients) and Objective Structured Clinical Evaluations. 3) The Awardee and other Faculty dedicated to this effort have been assured broad-based, long term institutional support, and will be assisted by a multi-disciplinary advisory Committee for the Preventive Pulmonary Program. 4) Design of an educational program for the awardee, together with Opportunities to implement new skills, will enhance his professional development and that of the Program.